Academic journal article Family Relations

Child-Rearing Practices toward Children with Hemophilia: The Relative Importance of Clinical Characteristics and Parental Emotional Reactions

Academic journal article Family Relations

Child-Rearing Practices toward Children with Hemophilia: The Relative Importance of Clinical Characteristics and Parental Emotional Reactions

Article excerpt

This study addresses the relative importance of clinical characteristics of the child and parental emotional reactions, to childrearing practices towards children who suffer from hemophilia. The variables were assessed in a Dutch sample of 108 zero-totwelve-year-old boys with hemophilia and their mothers. Data were analyzed using hierarchical regression analyses with clinical characteristics and emotional reactions as independent variables and child-rearing practices as respective dependent variables Mother's emotional reactions appeared to have a stronger influence on child-rearing uncertainty and overprotection than clinical characteristics of the son.

Key Words: appraisal, child-rearing, chronic illness, hemophilia.

Between 10% and 20% of children suffer from chronic illness (Midence, 1994). Chronic illnesses last for a long time and are often incurable. Patients often need to be treated and to maintain lifelong contacts with physicians and social workers. The illness and its treatment are a burden for chronically ill children and make a big appeal to their adaptability. However, the chronic illness of a child not only influences the functioning of the child, it also influences the functioning of the family (Bruhn, 1977; Kazak, 1989; Schwenk & Hughes 1983; Shapiro, 1983). Parental child-rearing behavior may be especially influenced by the child's chronic illness.

From the moment of diagnosis, parents of a child with a chronic illness may feel forced to reflect on their child-rearing practices quite consciously (Van Peer, 1991). Questions arise about current and future limits and possibilities for their child, about the way they should treat their child and about pedagogic goals which may need adjustment. Answers to these questions are not easily found, because the situation differs from the normal situations, rendering known strategies inadequate. This can lead to child-rearing uncertainty. Parents of children with asthma or mental retardation, for example, are uncertain about the way they should handle their child (Gresnigt & Gresnigt-Strengers, 1973; Van Peer & De Vries, 1986).

The physical vulnerability of the child may especially cause uncertainty in the parents. On the one hand, parents may tend to forbid certain activities in their efforts to protect their child against accidents which could lead to physical harm. On the other hand, they want to enable their child to explore the world, so that maximum development can occur. Parents have to balance these two imperatives. Failure in this respect may be one explanation for the fact that parents of chronically ill children show overprotective behavior more often and impose more behavioral restrictions on their child, than parents of healthy children (Bos, 1977; Gustafsson, Kjellman, Ludvigsson, & Cederblad, as cited in Eiser, 1990; Suurmeijer, 1980).

In brief, parents of chronically ill children, as a group, are more likely to experience pedagogic problems than parents of healthy children. However, considerable individual differences exist in response to the child's chronic illness (Eiser, 1993; Garrison & McQuiston, 1989; Kazak,1989; Schwenk & Hughes, 1983; Shapiro, 1983). For theoretical and practical (counseling) reasons investigation of explanatory factors is necessary. The traditional biomedical model tries to explain individual differences in terms of disease parameters, like diagnosis or severity within an illness. It neglects subjective factors, like the meaning of the disease to those involved. However, several researchers found that not so much the objective situation but especially the subjective meaning the parents attached to the illness, influenced their reaction to the chronic disease of their child (Athreya & McCormick, 1987; Eiser, 1993; Suurmeijer, 1980; Van Peer & De Vries, 1986).

This study addresses the relative importance of clinical characteristics of the child and parental emotional reactions to childrearing practices towards children with hemophilia. …

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